Head and face reconstruction

Alternative names:

craniofacial reconstruction; orbital-craniofacial surgery

Definition:

Surgical treatment to repair deformities of the head and face (craniofacial).

Description:

Surgery for head and face deformities (craniofacial reconstruction) depends on the type and severity of deformity and the condition of the patient. Generally, because surgical repairs involve the skull (cranium), brain, nerves, eyes, facial bones, and facial skin, a plastic surgeon (for skin and face) and a neurosurgeon (brain and nerves) work together.

The surgery is done while the patient is deep asleep and pain-free (under general anesthesia) and may take from 4 to 14 hours to complete. Some of the facial bones are cut and repositioned into a more normal facial structure. Pieces of bone (bone grafts) may be taken from the pelvis, ribs, or skull to fill in the spaces where bones of the face and head have been moved. Small metal screws and plates may be used to hold the bones in place. The jaws may be wired together to hold the new bone positions in place.

If the surgery is expected to cause much swelling of the face, mouth, or neck, the airway becomes a major concern. The airway tube (endotracheal tube) normally used for long surgical procedures under general anesthesia may be replaced with an opening and tube directly into the airway (trachea) in the neck (tracheotomy).

Indications:

Guidelines for craniofacial reconstruction include:

• birth defects (such as hypertelorism, Crouzon's disease, Apert's syndrome)
• injuries to the head, face, or jaws (maxillofacial)
• tumors
• deformities caused by treatments of tumors